儿童梨状窝瘘合并感染临床特征及病原学分析  

Clinical characteristics and pathogenetic analysis of piriform fossa fistula complicated with infection in pediatric patients

作　　者：张国锋[1] 李亚杰 岳铭[1] 丁道奎[1] 杨合英[1] 郭飞[1] 桑建中[2] ZHANG Guo-feng;LI Ya-je;YUE Ming;DING Dao-kui;YANG He-ying;CUO Fei;SANG Jian-zhong(Department of Pediatric Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Otolaryngology Head and Neck Surgery,the First Affliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院小儿外科,郑州450052 [2]郑州大学第一附属医院耳鼻咽喉头颈外科,郑州450052

出　　处：《医药论坛杂志》2024年第14期1489-1492,共4页Journal of Medical Forum

基　　金：河南省科技攻关项目(172102310059)。

摘　　要：目的探讨儿童梨状窝瘘合并感染的临床特点及病原学特征。方法回顾性收集2013年1月—2022年12月郑州大学第一附属医院收治的梨状窝瘘合并感染致颈部脓肿患儿临床资料,作为病例组,共39例,男25例,女14例。年龄24.0~192.0个月,平均(107.0±55.0)个月,中位年龄96.0个月。收集非梨状窝瘘颈部脓肿患儿资料,作为对照组。对照组患儿共25例,男13例,女12例。年龄14.0~192.0个月,平均(96.0±59.0)个月,中位年龄92.0个月。两组年龄<16.0岁,均为免疫力正常儿童。采用超声引导下穿刺或切开引流,留取脓液标本,送至细菌室进行培养,结果阳性者纳入,比较组间病原体特征,并对结果进行统计学分析。结果病例组病变位于左侧33例,右侧5例,双侧1例。脓液培养结果咽峡炎链球菌群22例(56.4%),非咽峡炎链球菌群17例(43.6%)。对照组病变位于左侧19例,右侧5例,双侧1例。脓液培养结果咽峡炎链球菌群4例(16%),非咽峡炎链球菌群21例(84%)。两组比较,年龄无统计学差异(P=0.451),性别无统计学差异(P=0.336),病变左右侧无统计学差异(P=0.656)。咽峡炎链球菌群在两组的分布差异具有统计学意义(P=0.001)。结论儿童梨状窝瘘合并感染可出现在不同年龄段,病变部位以左侧颈部为主,常见病原菌为咽峡炎链球菌群。一旦脓肿形成,建议尽早行穿刺或切开引流,同时选用敏感抗菌药物。Objective To investigate the clinical and pathogenetic characteristics of piriform fossa fistula with infection in pediatric patients.Methods The clinical data of pediatric patients with piriform fossa fistula complicated by neck abscess were retrospectively collected from the First Affiliated Hospital of Zhengzhou University between January 2013-December 2022 as the case group.The case group comprised 39 patients(25 males,14 females)with an age range of 24.0 to 192.0 months(mean age=107.0±55.0 months;median age=96.0 months).The control group consisted of children with non-piriform fossa fistula neck abscess.The control group included 25 patients(13 males,12 females)aged between 14.0-192.0 months(mean age=96.0±59.0 months;median age=92.0 months).Both groups were under 16.0 years old and had normal immunity.Ultrasound-guided puncture or incision drainage was performed,and pus samples were collected for bacterial culture.Positive results were included,and pathogen characteristics between the groups were compared and statistically analyzed.Results In the case group,lesions were located on the left side in 33 cases,right side in five cases,and both sides in one case.Pus culture revealed streptococcus anginosus group in 22 cases(56.4%)and non-streptococcus anginosus group in 17 cases(43.6%).In the control group,lesions were found on the left side in 19 cases,right side in five cases,and both sides in one case.Pus culture results showed four cases(16%)of streptococcus anginosus group and 21 cases(84%)of non-streptococcus anginosus group.There were no significant differences between the two groups in terms of age(P=0.451),gender(P=0.336),and laterality of the lesion(P=0.656).However,the distribution of streptococcus anginosus group between the two groups was statistically significant(P=0.001).Conclusion In children with piriform fossa fistula complicated by infection,the condition can manifest at various ages,predominantly affecting the left neck region,and streptococcus anginosus group is commonly implicated as the c

关 键 词：鳃瘘 脓肿 病原菌 

分 类 号：R762[医药卫生—耳鼻咽喉科]